A retrospective study of 119 cases of fracture of the proximal phalanx is described. The short incomplete sagittal fracture (split pastern) was most common and carried a good prognosis for a return to racing following conservative treatment. Longer incomplete fractures also had a good prognosis but complete fractures, either through the lateral cortex of the proximal phalanx or through the bone into the proximal interphalangeal joint, required internal fixation. Careful assessment of these and comminuted fractures was essential before surgery was undertaken. Most comminuted fractures were treated with a view to the animal retiring to stud rather than racing again. Humane destruction was considered to be justifiable for such fractures in colts or geldings of no stud value or if the fracture was severely comminuted.